


Obvious Things

by diandrahollman



Category: Sherlock (TV), Sherlock Holmes & Related Fandoms
Genre: Angst, Friendship/Love, Medical Examination, No Eurus Holmes, Other, POV John Watson, Partly s4 compliant, Sherlock Being Sherlock, TFP didn't happen, intersex sherlock, male with female genitalia (forced trans in infancy?)
Language: English
Status: Completed
Published: 2017-11-04
Updated: 2017-12-01
Packaged: 2019-01-29 12:10:09
Rating: Mature
Warnings: No Archive Warnings Apply
Chapters: 3
Words: 4,331
Publisher: archiveofourown.org
Story URL: https://archiveofourown.org/works/12630783
Author URL: https://archiveofourown.org/users/diandrahollman/pseuds/diandrahollman
Summary: "I confess that I have been blind as a mole, but it is better to learn wisdom late than never to learn it at all." - The Man With the Twisted Lip





	1. Chapter 1

**Author's Note:**

> This will cover the canon of the BBC show up until "The Lying Detective", then it will become ACD cannon compliant. By which I mean Eurus doesn't exist and that bullshit about Victor Trevor being a dog didn't happen. 
> 
> The title comes from this quote: "The world is full of obvious things which nobody by any chance ever observes." - The Hound of the Baskervilles
> 
> I am not LGBT myself - I am just an ally - so forgive me if I get terminology wrong. Also, I am American (I am so sorry), not British, so I could get some things wrong there too.
> 
> Disclaimer: Characters once belonged to Arthur Conan Doyle, specific plots belong to Mofftiss and the BBC which I'm beginning to think Doyle would be pissed about.
> 
> Dedication: For Emilio and any other LGBT readers I may have. And for fellow fans of the ACD stories who are still baffled by that last episode.

The first time Sherlock came to see me as a patient was shortly after our first encounter with Irene Adler. Of course, the fact that he felt the need to act clandestine about it partly explains why I reacted badly.

"You think this is funny, do you," I asked, holding up the clearly fake file for William Sigerson.*

"I apologize for the deception, but I feared you would not take the appointment if I used my own name."

I sighed and laid the file on my desk. "What is it you want, Sherlock?"

"My previous GP has recently retired from practice. I was hoping you would agree to replace him."

"Fine, but for the record you could have just asked."

"I *am* asking."

I sighed. "Right. Where is your medical file then?"

He frowned and waved toward the Sigerson file. "You have it."

"No, the real one."

"That is the real one. I simply changed the name for the sake of discretion."

"No, that file is for a transgender male, which I am reasonably certain I can conclude you are not."

"It doesn't say anything of the sort. It says I am male with female genitalia."

"That's what the term transgender implies."

"It would *imply* that I was once a different gender, which is not true."

"This is ridiculous. I've lived with you for more than a year. I've seen you naked. Your *genitalia* is most definitely male."

He reached into the pocket of his coat and produced an object wrapped in a Tesco bag. "You see, but you do not observe," he said quietly as he unwound the plastic and set the incredibly lifelike false penis on the exam table.

There was a long, uncomfortable silence as I stared dumbly at the thing, unable to think of a thing to say.

Luckily, Sherlock Holmes was never very good at waiting for someone to actually ask questions.

"I believe the correct term is 'intersex'. I was born with indeterminate gender. The doctor who delivered me was an idiot. He convinced my parents that it would be less psychologically damaging if they raised me as a girl than as a boy with an improperly formed penis."

I continued to stare at him like an imbecile as words - both from him and his chart - swirled through my head. Female genitalia. Improperly formed. Hormone therapy. Part of my brain still couldn't quite process that it wasn't some sort of trick or joke.

"John."

"Hmm? Right." I shook myself from my stupor and tried to recover my professionalism. "Er...what do you need then?"

"My hormone therapy requires annual physicals."

Right. I knew that. "Okay." I reached for the thin gown in the cupboard and set it on the chair meant for patients. "I'll let you change into that. Opening in front." I picked up the file again and hesitated. "Would you like someone else in the room?"

"That would defeat the purpose of making the appointment in secret under a false identity, wouldn't it?"

"Yes, but...I mean..."

"I came to you because I trust you, John."

I considered arguing, but thought better of it. "Right."

I took the file back out into the hallway and really looked at it this time. When I had walked into that room, I had been expecting a woman with an affected contralto voice and Adam's apple. A woman who had spent at least part of her life as a man. According to the chart, the patient was, at least physically, a post-op woman. Labia, vagina, prostate gland. But when I flipped to the prescribed medications, the list confirmed that his "hormone therapy" was consistent with a transsexual *man*. Which made sense as he had no testicles to produce testosterone in.

I couldn't help but think back over his interactions with Irene. He had been flustered and intrigued by her, but not, I remember noting, aroused. I had wondered about that. Did it say something about his sexual preferences? Did he even have any sexual preferences?

Was he actually aroused and I didn't notice because he didn't have the visible tent in his trousers that I would have expected?

I shook the thoughts away. It didn't matter. It didn't change anything.

I tried to compartmentalize before going back inside. Sherlock was my best mate. My flat mate. But while he was in my exam room, he would be just another patient.

He was sitting on the exam table, wrapped in the ill-fitting gown, a paper privacy drape covering his lap. His clothes were piled on the chair by my desk. 

I pulled up the detailed file on my computer to check for any red flags. Other than the gender issue, there was nothing I didn't already know. Occasional smoker. Former drug addict. No allergies. I took his pulse and blood pressure. Then I pulled on a pair of gloves and ran through the rest of the basics. I checked his ears, nose and throat, listened to his heart and lungs and did a visual check of his skin for any abnormal markings.

Finally, unable to stall any longer, I directed him to lay back and put his feet in the stirrups that extended from the end of the table so I could do a pelvic exam. 

I helped him arrange the drape over his knees, staring at the freckle pattern on his neck all the while. I'm pretty sure I was more embarrassed than he was.

He noticed. Of course he did. His hand covered mine for a moment as it rested on his hip to guide him to the edge of the table. "It's all right," he said softly.

I nodded. Of course it was. Still, I stalled a little longer by warming the speculum in the sink and had to brace myself as I positioned my stool and sat between his knees. 

I knew what to expect by then, of course, but there was still something disorientating about seeing female reproductive anatomy on an otherwise entirely male body. It was obvious he shaved his pubic hair, even though he hadn't done in recent days. No doubt to make attaching and - I shuddered to think of it - detaching the prosthetic easier. I ran my fingers along his pelvic bone, over scars long faded. 

"You have a bit of skin irritation here." 

"That's why I don't always wear the prosthetic," he said, addressing the ceiling. 

"You, er...you ever consider a more permanent solution?"

"If you are referring to a sex change, then no. I've already been through one and the process of stitching a more permanent appendage on my person purely for decoration seems ridiculous and unnecessary. Not to mention painful."

I lubricated the warmed speculum and slid it inside him, apologizing as his breath caught. There wasn't much to look for there as he didn't have a cervix or a uterus. Just a perfectly healthy looking proto vagina. "So why have the prosthetic at all," I asked innocently to distract him.

"I only wear it if I think it's absence will be noticeable. To avoid questions or suspicion. Most of the time people don't notice. Even you."

I wasn't sure if he was disappointed at my lack of observational skills or simply gloating at his ability to fool me. I decided it was best to ignore it. I removed the speculum and set it on the tray. "Would you be all right if I checked your prostate like this or would you be more comfortable..."

"This is fine," he interrupted. 

"Okay." I hesitated a moment, not quite sure what to do with my other hand, trying to recall what I usually do with other male patients. I put more lubricant on my index finger even though I probably didn't need it. "Try to relax," I remembered to say before sliding the finger into his vagina and feeling along the front wall. 

He inhaled sharply and I realized belatedly that the gland was much closer than it would be on a typical male patient. I muttered an apology and gentled my touch. I worked as quickly as possible, so focused on the immediate task that I didn't notice until much later that he was holding his breath.

"Right," I said brightly as I backed away from him and took off my gloves. "Everything looks perfectly normal. You can put your clothes back on."

I turned my back on him so I could finish noting everything in his file and write a prescription, half listening as he slowly dressed. Once I was sure he was decent, I turned to hand him the prescription. "Topical cream for the skin irritation. If it doesn't improve, let me know. You might want to consider using a different adhesive."

His lips twitched as he took the slip from me.

"I'll see you back at the flat?"

That reminder that nothing had really changed finally put him at ease. He nodded. "Thank you, John."


	2. Chapter 2

**Notes for the Chapter:**

> Thank you to everyone who has left comments and kudos so far. :)

Looking back, it strikes me how easily everything went back to normal after that first visit. It shouldn't really have been shocking as there was no reason for anything to change, but some part of me feared I had crossed some sort of line into unknown territory. I found myself second guessing his interactions with Irene and, later, Moriarty, but as ever, his sex life (if he even had one) was none of my concern so long as he didn't do anything that required medical treatment. 

And then the bastard had to go and fake his death.

I was so furious about his deception - that he had let me mourn him for two goddamn years - that I didn't notice the damage his time away had done to him. It was only in hindsight that I realized how much higher his voice was, how he had a slight lisp. How terrified he was that his little stunt had cost him my friendship.

Unfortunately, I didn't realize any of it until after I gave him a bloody nose and aggravated who knows how many other injuries.

Mycroft had seen to his treatment and refilling of his hormone supplements immediately after his rescue, so he didn't come to me until after he pulled that ridiculous stunt with the bomb beneath Parliament. 

He was quiet and more cooperative than I could remember him ever being while I checked his pulse, blood pressure and temperature. But when I went to push the gown aside so I could listen to his lungs he flinched and pulled it tighter around his body.

I froze. "Sherlock?"

"Sorry," he mumbled, slowly loosening his grip and allowing me to expose his back.

Doctors are supposed to maintain a professional detachment when dealing with patients. That's what makes treating a loved one or a friend so difficult. You have to remain stoic and neutral and treat them as you would anyone else when confronted with their pain and suffering. I never struggled so much with this as I did when I saw the scars on Sherlock's back.

I found an undamaged spot to place the stethoscope and went through the routine instructions to breathe and cough while I checked each lobe. But part of my attention was still on the scars, verifying that they were healing properly, torturing myself with thoughts of his dramatic re-entry into my life. I had tried to strangle him. I had tackled him to the ground twice, blinded by rage. I had been so concerned with what he had done to me two years earlier that I had not considered what might have happened to him since. He had hurt me, certainly, but I had also hurt him.

I drew the gown up again gently and came around to face him. He wrapped the gown tighter around himself instinctively. I wondered how I failed to notice the faint, healing bruises around his wrists.

"Don't," he whispered. 

I frowned, but before I could open my mouth to ask what he meant, he continued. 

"You were about to say something trite like 'I'm sorry'. Don't."

I wanted to argue, to tell him that I WAS, in fact, sorry and not in the vague 'I'm sorry this happened to you' sense, but in the very real 'I added to your pain' sense. But it would do no good. He was, as ever, too proud to acknowledge any glimmer of weakness. 

"Right." I grabbed the opthalmoscope and distracted us both from the inevitable for a while by checking his ears and throat. He followed my instructions easily, but his discomfort was obvious in his refusal to look me in the eyes. 

I entered all the numbers and checks in his electronic file. While I still had my back to him I asked "have you been sexually active since your last visit?"

"Yes."

I nodded and kept my voice level as I asked "how many partners?"

"Four."

I hesitated before recording any of that information, closing my eyes as if I could will it away. I knew it was possible those individuals had obtained Sherlock's consent first, but I was not naive enough to assume it was likely. After all, Mycroft had admitted - far too late - that he had rescued his brother from a Serbian prison where he had been at the very least beaten and sleep deprived. 

I cleared my throat. "And ah...did you use protection?"

"Not every time."

I was caught between relief at the evidence that SOME of those sexual encounters must have been consensual and the possible confirmation that at least one of them hadn't been. I took a moment to compose myself while I verified that Mary had obtained a urine sample. I added a note requesting blood work as well. Then I moved my chair in front of him. 

"Are you sure you don't want someone else in the room?"

We had had that exact conversation before. And he gave the same response: that he trusted me and no one else. 

He allowed me to help him position himself on the table, only snapping at me to stop "coddling" him once when I offered to fetch him another pillow for his back.

Despite all his insistence that he was FINE, he still hesitated when I coaxed him to open his legs wider. In that hesitation - and in the visible stiffness of his muscles - I could sense both his fear and his determination to hide it.

"You tell me if I do anything that makes you uncomfortable," I murmured before I began feeling along his abdomen and pelvis, trying to keep my touch gentle but unhesitant. Professional. Detached. At the same time, I had to be especially attuned to him because I didn't trust him to simply TELL me if he needed a moment.

He stared at the ceiling, his breathing calm and measured. He remained that way while I warmed the speculum and - with plenty of warning and more than a little hesitation - positioned it gently inside him.

There was very little physical evidence of a sexual attack so long after the fact. Some minor scaring and bruising. But there were scars I couldn't see and I could only guess how deep they went.

I decided I could forgo the prostate check for the time being. I removed the speculum quickly and carefully and gave him enough room to sit up. I pretended not to notice how he trembled slightly as he lowered his legs from the stirrups, forced myself not to rush to help him sit up. I tossed my gloves in the bin and faced him, sitting as close as I dared without invading his space. "You can talk to me, you know," I said tentatively. 

"I don't want to talk," he grumbled. "There's nothing to talk about."

I bit back a sigh and took out my prescription pad and a pen, scribbling a number on the top sheet and handing it to him.

"What's this for?"

"It's the number for my therapist. Don't argue with me. You have to talk to someone eventually."

His eyes slid away from me.

"I'm also scheduling you for a blood test."

"Mycroft has already..."

"Yeah, well, it doesn't hurt to have a second one."

I could tell he had an argument right on the tip of his tongue. But he held it back. He nodded and reached for his clothes.

I hesitated then, my professionalism at odds with my desire as his friend to comfort him - to hug him. I reminded myself that even in that capacity he was unlikely to welcome such a display of "sentiment". So I simply patted his shoulder awkwardly and gave him the room.

I didn't find out until much later that he never did make an appointment with any therapist.


	3. Chapter 3

**Notes for the Chapter:**

> This...turned out a lot angstier than I originally anticipated, although I did see this final scene in my head all along. Thank you to everyone who has read and left comments and kudos!

The degree to which Sherlock threw himself into the wedding was surprising to everyone, except, perhaps, Mary.

"You know when you're scared of something you start wishing it sooner just to get it all going? That's what he's doing."

I took her advice and tried to distract him with a case, but it didn't work for long.

The first time I kissed him was on my stag night. We were both thoroughly pissed by that point, so it was easy to play it off as a sort of accident - a display of friendly affection gone just a bit further than was intended. Especially as the sense that I had gone too far penetrated my inebriated mind right away, compelling me to pat him heavily on the cheek and slur "cheers, mate!" Sherlock seemed just as happy to brush the moment away as I was and we agreed, as we spent the night in a jail cell for drunk and disorderly, to never speak of it again.

I barely had a chance to settle back into something resembling a normal life before I was drawn into the Magnusson case and my pregnant wife's sordid past was brought to light. I spent a lot of hours in hospital making sure the number of doctors and nurses who knew of Sherlock's condition was kept to a minimum. I had no idea if Janine knew and I never dared ask. The stories she told the gossip rags were vague enough that it was impossible to tell whether they had been intimate or not.

I didn't find out until later that Magnusson had visited Sherlock in hospital. That he had threatened Mary and our child. That he had practically bathed Sherlock's hand with his tongue and commented on Sherlock's "womanly" attributes, touching the inside of his thigh just high enough to make it clear that he knew what he would find if he went higher. I know the incident alone was not what drove Sherlock to do what he did, but I'm certain it was one of the details that went through his mind in the moments before he pulled the trigger. Evidence that Magnusson had no threshold beyond which he was unwilling to go. He could get away with anything right under the noses of the people who could have him arrested, but wouldn't. 

Sherlock seemed willing to throw himself into protecting and caring for Rosie after that. Only we never got much of a chance at normal again before Mary's past caught up to her. We both hit rock bottom when she died. In my helpless grief, I pushed Sherlock away. In my state I could barely care for myself and my daughter, much less act as his minder. It never occurred to me that we might be able to help each other. Of course, he validated my reservations by drugging himself nearly into oblivion. 

When I saw Sherlock wielding the scalpel and screaming at Culverton Smith to stop laughing I went on autopilot. Disarm and neutralize the threat. But once I slapped him to try to snap him from his hysteria I couldn't stop the outpouring of all the rage I had been keeping firmly stoppered. I was angry at myself just as much as him, but that was partly because I feared I had allowed him to fall so far. Too far. The idiot was spinning dangerously out of control and people were going to be *hurt*.

"Let him do what he wants," he had mumbled, spitting blood on the morgue floor. "He's entitled. I killed his wife."

It took a long time for me to realize he wasn't just being dramatic. He genuinely believed those words to be true.

He was released from hospital into my care. As living in the flat I'd shared with Mary had grown too painful, I moved back into 221b with Rosie. Mrs. Hudson, Lestrade and Molly dropped by for frequent "visits". It was obvious they were just checking up on us, but I was grateful for it. Even if I did suspect they were making sure I didn't kill Sherlock.

Other than keeping watch to make sure he didn't sneak drugs back into the flat, I left him alone. And aside from a couple tentative attempts to play with Rosie or change her diaper, he stayed out of my way as well.

It was on the third night that I woke with the feeling that something was wrong. Rosie wasn't crying. She always woke me at least once during the night like clockwork.

My panic ratcheted upward as I peered into her crib to find it empty.

I stumbled down the stairs, through the kitchen door and into Sherlock's bedroom. His bed was empty too. 

Luckily, I thought to search the remainder of the flat before sounding the alarm. I found them on the sofa, Rosie curled peacefully on Sherlock's chest, her thumb in her sleep-slackened mouth.

"If you had checked your phone, you would have seen that I left you a text," Sherlock whispered as I collapsed to my knees beside them.

I reached for Rosie, but hesitated, my hand hovering over her back. She was fast asleep, her ear pressed to his left breast. No doubt the sound of his heart beating had helped soothe her.

I looked at the bruises on his face - both the ones I had given him and the ones Culverton Smith left behind when he proved Sherlock right about him. I came frighteningly close to letting that heart stop beating. To letting a lunatic kill my best friend - a man who had saved my life in many ways and who had put himself in harm's way in an effort to do it again. Yes, I had saved his life on several occasions as well, but I was a soldier. A doctor. That was my duty. Sherlock...

I hadn't seen Mary hovering around since the Culverton case ended, but I could still hear her voice in my head. 'He loves you,' she said at that moment. 'And he loves her. He worked out Rosie's schedule and smuggled her from the room before she could wake you. Bet she never even cried. Bet he timed it just right.'

I felt tears prick at my eyes as a thought crystallized in my mind. 

At the wedding, Sherlock had described himself and Mary as the two people who loved me most in the world. What he didn't know, perhaps, was that I shared that sentiment. They were the two people I loved most in the world. Sherlock probably thought he had been replaced when Rosie was born, but that wasn't true. My world simply expanded to encompass all three of them. 

I learned the hard way that I could never stop loving any of them. I would always love him just as I would always love Mary.

This was my family now. A mad detective and the daughter I had with the woman we both lost. I could never survive if I lost them too.

I stood and held out my hand to Sherlock. I told myself I imagined the way he flinched ever so slightly, as if he feared I might hit him again. He was just surprised.

He warily accepted the hand up from the sofa and let me guide him back into his bedroom. I helped him settle into bed, gently so we didn't disturb Rosie too much. She stirred, made a few unhappy noises, but didn't wake. I tucked the blankets around both of them, then fetched another blanket and arranged it beside them. Sherlock stared at me silently throughout the process.

After I climbed beneath the covers I leaned in to kiss Rosie's head softly. And then I pressed an equally gentle kiss to the scar bisecting Sherlock's left eyebrow.

The tiny, startled breath he took was more of a hiccough than a gasp.

Entirely overcome by the impulse, I brushed my lips over his closed eyelid - the one that was still somewhat bloodshot - and then his cheek. He was holding his breath.

"Forgive me," I whispered against his lips.

His nose bumped against mine as he nodded. And then I was kissing him. Softly. Gently. An apology.

He reached for my face and for a moment I thought he meant to press me closer - or push me away - but his thumb just delicately brushed beneath my eye and I realized I was crying after all.

I sagged against him, burying my face in his shoulder. His arm came around me, holding me in a loose embrace. As I calmed, I realized what a pathetic sight I must make. A perfect mirror image of my nearly one year old daughter, curled on Sherlock's chest.

"It's all right," he whispered, no doubt sensing the line of my thoughts. 

"No, it isn't," I murmured. I rested my hand on Rosie's back, over Sherlock's, completing the circuit. Grounding myself.

"No," he agreed. "It is what it is." 

This was my family. And it was the only family Rosie would ever know.

I fell asleep not long after, soothed by the sound of the two living people I loved most breathing in the quiet of the dark bedroom.

**Author's Note:**

> *William Siegerson is an alias Sherlock used in Doyle's original stories.


End file.
